EMQ practice - Treatment of respiratory infections

• Standard therapy for community-acquired pneumococcal pnemonia not requiring hospital admission
• Oral amoxicillin
• Oral erythromycin if patient is allergic to penicillin
• Can even combine with amoxicillin if an atypical organism is suspected
• 35 year old, ward, pneumonia, HAI
• Intravenous ceftazidime
• Third generation cephalosporin for gram negative bacteria that causes HAI
• 40 year old, builder, severe community acquired pneumonia, atypical pathogens
• Intravenous cefuroxime and erythromycin
• Standard therapy for community-acquired pneumonia
• Rifampicin added empirically if high clinical suspicion of legionella infection
• 22 year old, HIV positive, anti-retroviral therapy, Pneumocystic carinii pneumonia
• Intravenous co-trimoxazole
• Treatment of choice is high-dose co-trimoxazole delivered intravenously for 2-3 weeks
• Intravenous pentamidine may be used if co-trimoxazole is contraindicated or not tolerated
• Corticosteroids are used as an adjunct if there is hypoxaemia
• Trimethoprim and sulfamethoxazole, folic acid synthesis inhibitors
• 19 year old, male, pneumonia with symptoms of headache, fever and dry cough, chlamydia infection
• Oral tetracycline
• Chlamydial pneumonia often presents with a biphasic illness: upper respiratory tract symptoms precede pneumonia
• Diagnosis is usually made retrospectively